Page:The American Cyclopædia (1879) Volume IV.djvu/524

 512 CHOLERA it reached Mecca on the Red sea by May 2 ; in Alexandria, June 2, cases were frequent; from there it was carried by steamships to Smyrna, Constantinople, and up the Black sea; to Malta, Ancona in Italy ; to Marseilles, Gibral- tar, Barcelona, Algiers, Tunis ; and to South- ampton in England by the steamship Poona by July 10, with 120 cases of cholera by July 24. But more especially the disease was conveyed up through France from Marseilles to Paris and Havre ; and emigrant ships quickly transported the disease over to America, principally to New York. From New York it was distributed in 1866 in every direction over the United States, by railroads and steamboats, even as far west as the Smoky Fork river in Kansas ; to Forts Riley and Barker, and to the new town of Ellsworth, then only six weeks old, be- cause soldiers, railroad laborers, and others from infected districts brought the disease to the new line of railroad then building. Thus we have sketched the great route lines of cholera and the great 12-yearly epidemics. The next one, if our theory is correct, will be a Juggernaut one in 1877, supplemented by a Hurdwar cholera in 1879 ; although the con- stant intercourse of Russia with central Asia, and her expeditions in Turkistan, may be the means of introducing a lesser epidemic into Europe, as they are doing at the present time. But in 1877 and 1879 we may expect an out- burst of the disease, such as there was in 1781 and 1783, 1817 and 1819, 1829 and 1831, 1841 and 1843, 1853 and 1855, and 1865 and 1867. As Hindostan, in which cholera always origi- nates, lies to the east and south of Europe and North America, the prevailing direction in which the disease always advances is to the west and north ; but as it always proceeds along the lines of the greatest and most rapid travel, it often doubles back upon itself. Thus in 1832 it was carried south from England to Holland and France, down to Marseilles ; east to Italy, up toward Vienna, and south to Malta toward Alexandria; also down to Spain and back through the Mediterranean. In 1841 and 1842 it was carried by English troops from India to China, back toward Burmah, central Asia, and Bokhara, south into Hindostan as far as the mouth of the Indus, and low down the Ganges. In the Crimean war it was carried east from France and Algiers to Turkey. In 1865 it was taken from Alexandria to Constan- tinople, from there across the Black sea to Tre- bizond, Circassia, and Armenia, toward Per- sia. In our next contests with the disease our whole safety lies in quarantine and thor- ough disinfection. Bokhara, the holy city of central Asia; Meshed, the holy city of Per- sia; Mecca, the holy city of Arabia; and the huge pilgrimages to and from them, are the first great outposts of danger. Next come the great distributing ports of Alexandria, Trebi- zond, Poti, Astrakhan, and Orenburg; next Constantinople, Odessa, and the Baltic ports ; next Marseilles, Havre, and Liverpool ; finally our Atlantic ports. The disease can be stopped 1 at any one of these outlets and inlets. It has never yet been carried across the Pacific ; but with the vast increase of our Pacific commerce with China and Japan, it must sooner or later reach California from that direction. As all the most virulent epidemics, from Hurdwar to London, have been connected with the con- tamination of drinking water by cholera evac- uations, there is but little danger of a very extensive outbreak of the disease in any city where the drinking water is originally pure and is conveyed in close and clean pipes. Water sources must be zealously guarded ; and it should be regarded as a penal offence, always to be followed by prompt and severe punish- ment, to foul the tributaries of a stream fur- nishing drinking water to any community.. Cholera pollution of wells, springs, fountains, pumps, and small streams is only too common in all parts of the world, and is the most pro- ductive source of severe local outbreaks of the disease, and may always be suspected in every instance in which many cases occur simultane- ously in one house, family, or neighborhood. There is even reason to believe that pure drinking water may become contaminated if left standing long in cholera wards, in open vessels ; at least, a substance as virulent as croton oil has been condensed from the atmo- sphere of close and crowded cholera rooms. The ingestion of this water is vastly more fatal than the use of bad fruits or poor liquors ; but its dangers may generally be prevented by simple boiling, or filtering through charcoal, or by adding a few grains of permanganate of pot- ash. With these precautions cholera patients may be attended with great safety, provided the nurses be kept scrupulously clean, and no- cups, plates, or drinking vessels be touched with soiled hands. Dust inhaled from cholera- soiled clothes, carpets, or floors is the next most dangerous substance; but the effect of this is confined to single rooms, houses, fami- lies, and confined spaces, and can never rise to- the dignity of the cause of a great and extended epidemic. As the poison of the disease always proceeds from the cholera evacuations, these should be disinfected instantly and thoroughly ; and common salt is perhaps as good a disinfec- tant as any. Strong solutions of salt, or weaker ones of sulphate of iron (copperas) or sulphate of zinc (white vitriol), 1 part to 10 of water,, should be kept in the bed pans or vessels; soiled bed and body clothes should be put, be- fore removal from the sick room, into a disin- fecting solution of salt, chloride of soda, weak carbolic acid, permanganate of potash, or chlo- ralum, and then subjected to careful washing out of doors. The floor of the sick room should always be bare of carpets, and may be sprinkled or washed with a strong solution of salt or chloralum, or the chloride of aluminum, all of which possess several advantages. They are not poisonous, are inodorous, and are very cheap. They prevent decomposition and re-